[Classification, differentiated and topic diagnosis, and treatment of hepatic cystic lesions].

Accumulated in 2004-2014 yrs in Department of laparoscopic surgery and choledocholithiasis experience of treatment in patients, suffering parasitic and nonparasitic hepatic cysts, was analyzed. Own improved classification of hepatic cystic lesions was proposed. Peculiarities of performance of open operations, of the puncture miniinvasive operations and interventions for hepatic cysts, using laparoscopic approach, were enlighten. Main indications for surgical treatment of hepatic cysts were adduced, depending on their kind, size, localization and clinical signs.

[Comparative estimation of open and mini-invasive interventions in the treatment of hepatic abscesses and accumulations of liquid of postoperative genesis].

A comparative aspect of the treatment results for pyogenic hepatic abscesses and extraorgan accumulations of postoperative liquid, using transcutaneous ultrasonografically controlled and open-access interventions, was studied up in 328 patients. The efficacy and concurrent ability of miniinvasive technologies in such patients was proved.

[Methodological and tactico-technical basics of transcutaneous echocontrolled interventions].

The main terminologic entities, which characterize transcutaneous echocontrolled interventions, are analyzed. The basics of technique of transcutaneous puncture and drainage conduction under ultrasonographic examination control, the accesses variants, indications and contraindications for their application are presented.

[Ultrasonographic diagnosis and characteristic of postoperative accumulations of a liquid].

Ultrasonographic semiotics of extraorgan localized postoperative accumulations of a liquid occurring after performance of interventions on a liver was studied up. There was established the dependence of their localization on the operation kind. The differential diagnosis algorithm of some pathologic conditions (haematoma, biloma, seroma) was elaborated.

[The role of percutaneous interventions under the control of ultrasound examination in the treatment of postoperative fluid accumulations in suborgan space].

There are adduced the results of transcutaneous interventions under ultrasonographic investigation guidance in 106 patients, performed for extraorgan liquid accumulations (ELA)--chylomas, haematomas and seromas. There were elaborated indications for punctures and drainage application, algorhythm of treatment was proposed, taking into account peculiarities of every pathologic condition. Efficacy of minitraumatic methods in radical treatment of ELA, which may serve as an alternative for reoperation conduction and have certain advantages over them, was proved.

[Ultrasonographic diapeutics of the hepatic abscess. Possibilities and achievements].

Transcutaneous interventions (TI) under ultrasonographic control were applied in 163 patients (the main group) for primary pyogenic hepatic abscess (PPHA). For comparative group 31 patients were included, in whom an operative intervention was done (disclosure, sanation and external drainage of the focal lesions). While treating PPHA in 91 patients the TI punctures under ultrasonographic control were made and in 72--transcutaneous drainage was performed. The puncture treatment appeared effective in 88 (96.7%) patients, drainage--in 70 (97.2%), summarized efficacy of TI had constituted 96.9%. The morbidity ratio after miniinvasive treatment of PPHA was lesser than after routine operative treatment. The TI application for PPHA is an effective method of the patients treatment, not dependent on their foci size and the patient general state, it permit to lower morbidity, lethality and period of hospitalization significantly, and to improve the results meaningfully. TI under ultrasonographic control constitutes the method of choice in PPHA treatment, excluding posttraumatic abscesses, chronic hepatic abscesses and intracavitary sequesteres presence.

[Modern possibilities of complex miniinvasive treatment of echinococcal hepatic cysts].

Ultrasonic features were studied and criterions of differential diagnosis were elaborated for parasitic one-chamber cysts (types I-II according to Gharbi classification) and for true cysts in 35 patients with hydatid hepatic disease. Transcutaneous interventions under ultrasonic guidance with preliminary application of therapy course using vormil was applied as the method of radical treatment. Pathomorphosis of residual cavities in terms of observation from 1 to 10 years was studied. There was proved the efficacy of combined application of miniinvasive method of radical treatment of patients, which may serve as an alternative to surgical intervention and has some advantages over it.

[Ultrasonographic diagnosis of hepatic polycystosis and the place of transcutaneous interventions under ultrasonographic guidance during palliative treatment].

The hepatic polycystosis (HPC) signs are studied up and the disease course stages are formulated. Transcutaneous puncture (TCP) under ultrasonographic investigation guidance with subsequent residual cavity sclerotherapy was applied in 53 patients as a method of palliative treatment of the disease. Indications for the method application, the procedure technique and tactics of the patients management were elaborated. The method of a staged treatment using periodical TCP conduction under ultrasonographic guidance was clinically introduced. Its efficacy was proved as a self-supporting method of palliative treatment of the disease in different stages. The best results were obtained after operative treatment for significant HPC in a compensation stage (the first stage--open or laparoscopic fenestration) with subsequent periodical TCP conduction (second stage - supportive treatment). Such combined tactics we consider the most effective method of HPC palliative treatment.